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Regional characteristics of esophageal cancer and robot-assisted minimally invasive esophagectomy (RAMIE): an analysis of the international UGIRA registry

  • Yota Suzuki*
  • , Inderpal S Sarkaria
  • , Sangmin Kim
  • , Omar Awais
  • , Richard van Hillegersberg
  • , Jelle Ruurda
  • , Yin K Chao
  • , Peter Grimminger
  • , Zhigang Li
  • , Chunguang Li
  • , Chang Yuan
  • , Jens-Peter Hölzen
  • , Mazen A Juratli
  • , Andreas Pascher
  • , Hans F Fuchs
  • , Christiane J Bruns
  • , Luca Bellaio
  • , Vladimir Lozanovski
  • , Takeo Fujita
  • , Marc J van Det
  • Ewout A Kouwenhoven, Jan W Haveman, Boudewijn van Etten, Suzanne S Gisbertz, Mark I van Berge Henegouwen, Gijs I van Boxel, Jennifer Straatman, Magnus Nilsson, Ioannis Rouvelas, Tom Mala, Dag T Førland, Frank Benedix, Eric Lorenz, Philippe Rouanet, Anne Mourregot, Arul Immanuel, Simone Giacopuzzi, Shaun R Preston, Hiroyuki Daiko, Beat P Müller, Benjamin Babic, Katharina Beyer, Alexander Semaan, Silvia Jarosciakova, Hecheng Li, Paolo Strignano, Guillaume Piessen, Philip W Chiu, Marco Milone, Jan-Hendrik Egberts, Rubens A A Sallum, Giovanni Ferrari, James D Luketich, Evan T Alicuben
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Esophageal cancer is a global burden, and multiple international societies exist to address the issue in international collaboration. This study aims to analyze the characteristics of esophageal cancer and robot-assisted minimally invasive esophagectomy (RAMIE) across geographic areas. We performed a retrospective analysis of the Upper GI International Robotic Association (UGIRA) international database from January 2016 to April 2024. Forty centers worldwide that were known to perform RAMIE were involved in establishing this consortium. The patient characteristics, surgical techniques, and short-term outcomes of RAMIE were compared by each regional area (Europe, Asia, North America, and South America). A total of 3,916 RAMIE cases were registered in the UGIRA database (2,643 in Europe, 1,130 in Asia, 111 in North America, and 32 in South America). The median age was 66 years, and 80.5% of patients were male. Notably, Asia had a high prevalence of squamous cell carcinoma (91.2%) and predominant use of the McKeown approach (94.9%). BMI was lower in Asia, whereas comorbidities were more common in Western countries across all types. The use of neoadjuvant chemotherapy and radiation was lower in Asia (48.2% and 20.8 %, respectively). Postoperative complications also differed by region; pneumonia was most common in Europe and South America, cardiopulmonary complications in North America, and recurrent nerve injury in Asia. In conclusion, regional differences were observed in baseline characteristics, treatment approaches, and complication patterns in patients treated by RAMIE for esophageal cancer. Recognizing these variations is essential for fostering mutual understanding and advancing the field through international collaboration.

Original languageEnglish
Article numberdoag042
JournalDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
Volume39
Issue number2
DOIs
Publication statusPublished - Apr 2026

Keywords

  • Humans
  • Esophageal Neoplasms/surgery
  • Esophagectomy/methods
  • Male
  • Robotic Surgical Procedures/statistics & numerical data
  • Female
  • Aged
  • Retrospective Studies
  • Registries
  • Middle Aged
  • Asia/epidemiology
  • Europe/epidemiology
  • North America/epidemiology
  • South America/epidemiology
  • Minimally Invasive Surgical Procedures/methods
  • Treatment Outcome
  • Postoperative Complications/epidemiology

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